HomeMy WebLinkAboutStatement of OrganizationForm CPF M101: STATEMENT OF ORGANIZATION
CANDIDATE'S COMMITTEE
MUNICIPAL FORM
IV
Commonwealth Office of Campaign and Political Finance
of Massachusetts
File with: City / Town Clerk or Election Commission J
NOTICE IS HEREBY GIVEN in accordance with the provisions of General Laws, Chapter 55, as amended, of the orpnizaj m of a
candidate's enmmittee as fnllnws• r
CANDIDATE: Full Name:
Residential Address: ) 2
City / State / Zip:_ ('v� •, � oZ S S
E -Mail Address: lS y 1 � �� rV-) Phone #: .�, '7,?,/ jg/
Party Affiliation: 1 (If applicable)
SOUGHT/PURPOSE:
Title:
District: %f lil C
Name of Committee:
Committee Mailing Address:
,\1 V )e
(The name of the committee must include the candidate's last name)
City, State / Zip: 2LL!_ 1 y4 Phare #:
DFFICERS:
Chairman: Treasurer*: �) �r ��✓ \
Residential Address: / e,1Residential Address: —Y
City / State / Zip: M (]� SSV City / State / Zip:
Phone Phone #: �I , 51 V 3/ �b Email: .y) �') e 'J 64GL, � C
Other Officer/Title:
Residential Address:
City / State / Zip:
Phone #:
Other Officerfritle:
Residential Address:
City / State / Zip:
Phone #:
ry, with other officers and finance committee, if any.)
I hereby consent to the filing of this committee. I understand that a candidate shall not give consent to the organization of more than one committee on his/her
behalf. I am aware that candidates are required to keep detailed accounts and records of all campaign finance activity for a period of six years from the date of
the relevant election. )
SIGNED UNDER THE PENALTIES OF PERJURY: lCand''s
/
Date:
ignature
I hereby acceptthe office of Treasurer of the above-named ffirm that I am not a public employee as defined by M.G.L. c. 55, s. 13. I understand
that: 1) I am subject to certain duties and liabilities under Mcluding the timely filing of campaign finance reports and keeping detailed accounts
and records of all campaign finance activity for a period of six years from the date of the relevant election; 2) if after my acceptance of this office I become an
appointed public employee, I must resign this position and notify OCPF of my resignation; and 3) a candidate may not serve as treasurer of the political
committee organized on his/her behalf.
SIGNED UNDER THE PENALTIES OF PERJURY: Date: ZI l 1
Treasurer's si
I hereby accept the office of Chairman of the above-named committee
SIGNED UNDER THE PENALTIES OF PERJURY:
/u
Chaihnan's signature 2
DEFINITION OF A PUBLIC EMPLOYEE
M.G.L. Chapter 55, Section 13 states that a person who is employed for compensation by the Commonwealth or any county, city or town
(other than an elected official) may not directly or indirectly solicit or receive political contributions. Such persons may not serve as treasurers
of any political committee. If you are unsure of your status, please contact OCPF for further guidance.
SELECTED EXTRACTS FROM M.G.L C 55
Section 1 defines a candidate's committee:
"C'andidate's committee", the political committee organized on behalf ofa candidate .... The term "candidate's committee" shall also apply to
the campaign fund ofa candidate who has not organized a political committee for the purpose of caming out the election campaign of such
candidate or who receives contributions or makes expenditures independently of said committee.
Sedion 2 requires candidates to keep certain records:
Fvery candidate shall keep detailed accounts of all contributions received by him, or by a person acting on his behalf and of all expenditures
made by him, or by a person acting on his behalf. Said accounts may be kept by an agent duly authorized thereto, but the candidate shall be
responsible for said accounts, which shall be kept separate and distinct from all other accounts and shall include contributions made by the
candidate .... The candidate shall preserve all receipted bills and accounts relative to all contributions received, expenditures made and am
other campaign finance activity. ... The candidate shall preserve said receipted bills and accounts for six years from the date of the relevant
election....
Section 3 requires the director to:
'assess a civil penalty for any [late filed] report ... of twenty f ve dollars ($25) per day .... [up to $5, 000 per report]. In the case of failure to
file by a candidate or a candidate's committee, the civil penalty shall be assessed against the candidate ....
.Section S outlines statements of organization of political committees:
Each political committee shall organize by filing with the director or, if organized for the purpose ofa city or town election only, with the city
or town clerk, a statement of organization.
The statement of organization shall include: (1) the full name of the political committee, which, if organized on behalf of a candidate, shall
include the name of the candidate in said name; .... (2) the address of the political committee; (3) a statement of the purpose for which the
political committee is organized .... (4) the name and residential address of the chairman and the treasurer; (5) the name, residential address,
and position of other principal officers, including officers and members of the f nance committee, if any, and; (6) the name and address, if
known, and party affiliation of each candidate the political committee is supporting; provided, however, that if a candidate is nominated
without reference to a political party, the name of his political party shall not be required....
Any change in information previously submitted in a statement of organization shall be reported to the director, or if organized for the
purpose ofa city or town election only, to the city or town clerk, within ten days following the change.
F.ach political committee shall have a treasurer who shall qualify for his office by filing a written acceptance thereof with the director, or if
organized for the purpose ofa city or lawn election only, with the city or town clerk. Said treasurer shall remain subject to all the duties and
liabilities imposed by this chapter until his written resignation of the office is received or his successor's written acceptance is filed as
aforesaid. No person acting under the authority of, or on behalf of, any political committee shall receive any money or anything of value. or
expend or disburse the same, or incur expenses while it has no treasurer qualified as aforesaid....
Each treasurer ofa political committee shall keep and preserve detailed accounts, vouchers and receipts as prescribed for a candidate by the
provisions of section two. Each treasurer of a political committee shall keep said records for a period of six years following the date of the
relevant election ....
No expenditure shall be made for, or on behalf of, apolitical committee without the authorization of the chairman or treasurer, or their
designated agents ....
A11 funds ofa political committee shall be kept separate from any personal funds of officers, members or associates of such committee ....
IMPORTANT: M.G.L. c. 55, s. 5 requires that any changes in the information provided on this form shall be filed within ten (10)
days of said change. Further information can be obtained from OCPF by phone at (617) 979-8300, via e-mail at ocpfacpEstate.ma us
or on the web at http://www.mass.gov/ocpf.
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